| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $77.62 | $77.62 | $77.62 | |
Aetna
| Professional | $55.41 | $77.62 | $112.99 | |
Medica
| Facility | $77.62 | $81.50 | $115.25 | |
Medica
| Professional | $65.44 | $90.85 | $603.54 | |
United
| Professional | $62.43 | $78.98 | $119.07 |